LARRY EARL UNDERDUE

BISMARCK, ND
NPI1790388718
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
(Licence: ND  1478491)
Enumeration Date2020-11-20
Last Update Date2020-11-20
Business Address
Mr. LARRY EARL UNDERDUE
420 E MAIN AVE APT 1011
BISMARCK, ND 58501-4069
Phone number: 701-204-1642
Mailing Address
Mr. LARRY EARL UNDERDUE
420 E MAIN AVE APT 1011
BISMARCK, ND 58501-4069
Phone number: 701-204-1642
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